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 President Signs Comprehensive VA Bill That Will Give Veterans More Care Options

In a special White House Rose Garden ceremony on June 6, President Trump signed into law the VA Mission Act of 2018, which offers veterans more care options by authorizing Veterans Affairs (VA) provider agreements, or Veterans Care Agreements, for facilities offering extended care, including skilled nursing centers.

The move marks a celebratory end to a years-long American Health Care Association and National Center for Assisted Living (AHCA/NCAL) push to get the VA provider agreements into law. The comprehensive VA package passed both the House of Representatives and Senate in May.

AHCA/NCAL has been actively promoting VA provider agreements since 1988 that would allow LT/PAC centers to care for veterans in their communities or in close proximity to their families and support systems. The agreements had been supported by the Department of Veterans Affairs (VA), yet required statutory authorization.

“AHCA has been working with the VA on getting provider agreements across the finish line for three decades,” says Dana Halvorson, AHCA senior director of not for profit & constituent services.

“This day marks a monumental moment in ensuring our veterans have access to the quality care they deserve. I am proud that I have had the chance to work with AHCA members and our congressional champions on this important issue for those who have served our country so bravely,” she says. “Now, we will move forward on working with the VA to get this implemented in a manner that will allow veterans to have access to nursing centers in their communities.”

It is long-standing policy that participation in Medicare or Medicaid does not make providers federal contractors. However, if a provider currently has VA patients, it is considered a federal contractor and therefore must comply with statutes such as the Service Contract Act.

The Office of Federal Contracting Compliance Programs administers stringent reporting requirements and regulations, beyond those required by Medicare and Medicaid rules, which have dissuaded nursing care centers from admitting VA patients, AHCA/NCAL says. As centers already meet strict compliance guidelines under the Medicare and Medicaid programs, adding more regulations is inefficient, adds cost, and takes staff time away from caring for veterans, AHCA/NCAL has argued.

The result has been limited long term care options for veterans in their local communities, with some veterans having to choose between obtaining needed LT/PAC services in a distant VA facility and remaining near loved ones in their community.

Deborah Meade, chief executive officer at Health Management, in Warner Robins, Ga., is a third-generation owner-operator with 28 years in the LT/PAC profession. Health Management provides post-acute, skilled nursing, and assisted living care. She says that, due to restrictions of the past, her company had to drop contracts that would provide care to local veterans. It was a move that was incredibly difficult for Meade and her staff, she says.

“As a provider, I am thrilled to once again be able to provide quality care to our veterans,” says Meade. “They have given so much for us; we are honored to give back.”

Provisions in the VA Mission Act will also help remove some of the existing red tape that may prevent some providers from being able to provide care to veterans. According to the Senate VA Committee’s section-by-section description of the bill: “Section 102 would authorize VA to enter into Veterans Care Agreements (VCAs) that are not subject to competition or other requirements associated with federal contracts, so that they can more easily meet veterans’ demands for care in the community. 

“Eligibility for care would be subject to the same terms as VA care itself, and the rates paid under VCAs, to the extent practicable, would be in accordance with rates paid under the Veterans Community Care Program established in section 101 of this bill. VA would be responsible for development of a certification process for VCAs and a system for monitoring the quality of care.”

Participating providers, while not considered federal contractors for the purposes of this section, would still be required to follow federal laws related to fraud, waste, and abuse, as well as employment law.

It is also important to note that Section 107 would apply the same affirmative action moratorium on VCA contractors and subcontractors as is applied to TRICARE contractors and subcontractors, who provide civilian health benefits for U.S. Armed Forces military personnel and retirees.

Moreover, on May 18, 2018, the Department of Labor released an extension of the moratorium on enforcement of the affirmative obligations of TRICARE providers for another two years, expiring May 7, 2021.

AHCA/NCAL says the number of facilities able to serve veterans will increase in most areas once qualified providers are able to enter into VA provider agreements, broadening options for veterans who need both nursing center care and home- and community-based services.

VA says it will take approximately one year to implement the agreements, pending the issuance of regulations. 

Both Halvorson and Meade attended the White House bill signing event June 6.

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